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What’s behind Colorado’s new suicide prevention campaign? Real teen voices

A local, youth-led effort to promote a suicide text line was so successful, the state is copying it

Kirk Woundy, communications and grants manager for the National Alliance on Mental Illness affiliate in Colorado Springs, holds "Below the Surface" posters created for an awareness campaign to prevent youth suicide. (Mark Reis, Special to The Colorado Sun)
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In the span of two weeks, four students at Chad Hawthorne’s high school in Colorado Springs killed themselves. The deaths came every few days near the end of his freshman year, even as school officials scrambled to make them stop.

Across town at Alexis McCowan’s high school, a friend’s little brother took his own life last year. It was the first suicide to touch the young El Paso County charter school where students felt so protected from drugs and death that they called themselves the “bubble kids.”

The voices of Hawthorne and McCowan, along with a handful of other teens, are behind a new statewide suicide prevention campaign. Expect to see their messages soon on a social media post, chapstick tube or school wall near you.

Here’s how to get involved with suicide prevention, or find help

The campaign, created by the teens and coordinated by the Colorado Springs affiliate of the National Alliance on Mental Illness, or NAMI, was so successful in El Paso County, the state is copying it.

It’s called “Below the Surface” — as in a teen might look put together on the outside, but inside is feeling depressed, anxious or suicidal — and the posters are in-your-face honest. The whole point is to urge young people who need help to send a text message to an anonymous helpline that will start a live text conversation with a counselor.

Chad Hawthorne, 18, is reflected in a poster that is part of a National Alliance on Mental Illness awareness campaign to prevent youth suicide. Hawthorne, a senior at Discovery Canyon Campus High School in Colorado Springs, was one of a group of teens who helped work on the campaign. This poster is his favorite. (Mark Reis, Special to The Colorado Sun)

The text line has existed in Colorado for almost three years, but the state had yet to market it to its target audience: teenagers.

Until now. After seeing texts to the hotline more than triple in El Paso County, the state Office of Behavioral Health has spent $70,000 since October to expand “Below the Surface” statewide, creating a new website, short videos and a youth leadership program.

Texts from El Paso County reached 1,648 in 2018, including 687 from teens ages 13 to 17. That was up from 968 a year earlier, when the local campaign began. The line received 492 El Paso County texts from March 2016, when it went live, through the end of that year.

The average text conversation lasts 47 minutes.

Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.

Putting forth a good face but “struggling underneath”

Hawthorne and McCowan were among a group of young people invited by NAMI two years ago to brainstorm ways to tackle the teen suicide rate in El Paso County, one of four counties with the highest rates in Colorado. The county had 117 youth suicides from 2003-2017.  

The ideas went straight from the teens’ heads to a creative design team that developed posters, notecards and stickers advertising the little-known text line.

Each of the posters, which debuted in two El Paso County schools that agreed to pilot the project, starts with an attention-grabbing, positive message on the top half. And then on the bottom half, “below the surface,” is the truth that’s harder to see.

“I’m in love,” states one on a bright purple background. “But I’m scared to come out.”

“I’m happy. That people think I’m doing OK.”

“My good grades,” says the top of an orange poster, which continues, “Are never quite good enough.”

Kirk Woundy, communications and grants manager for the National Alliance on Mental Illness said there sometimes is a disconnect between what people “present to other people and what you are dealing with internally.”(Mark Reis, Special to The Colorado Sun)

By tracking texts to the crisis line in the 16 ZIP codes surrounding the two schools where the first posters appeared, researchers were able to show the extent of the campaign’s impact. Contact with the crisis line went from just 35 texts in the five months before the posters were up, to 103 text conversations in a five-month period afterward.

The posters first appeared in Manitou Springs High School and Atlas Preparatory School in Colorado Springs at the start of the 2017-18 school year. As word spread, more schools asked to display the materials.

By the end of that year, 16 schools in and around Colorado Springs were participating in “Below the Surface.” Now there are 40 middle and high schools — all in El Paso County, and the state’s campaign will expand the efforts to schools statewide.

NAMI had $75,000, mostly from the Colorado Springs Health Foundation, to create the project, including hiring a design firm and data tracking to measure the campaign’s impact. From the start, the organization realized the message had to come directly from teenagers, said Kirk Woundy, NAMI communications and grants manager. They pulled together a focus group of teens, asking them to comment on other suicide prevention pamphlets and marketing, and what they thought were the biggest stressors in teens’ lives.

“What came out of those conversations was an acknowledgement that for a lot of people, not just teens, the line between ‘you’ve got everything in control’ and ‘you don’t know what’s going on and where to take the next step’ is a really fine line,” Woundy said. “You can be putting forth a really good face but really be struggling underneath.

“There can be a disconnect between what you present to other people and what you are dealing with internally.”

Every poster came from a true story

Hawthorne, a senior at Discovery Canyon Campus High School, asked to join the advisory group because he was shaken by the four student suicides his freshman year, including the death of a classmate he had known since elementary school.

In the midst of the deaths, Discovery Canyon made final exams optional, the 18-year-old recalled. “They gave us a week where we went to school but we didn’t really do anything,” he said. “They were trying to figure out why it had happened.”

The fourth student took his life at the start of summer break, Hawthorne said. Since then, the school has adopted a program called Sources of Strength, which teaches students to recognize the signs of suicide or depression in online posts and how to help each other connect to trusted adults.

Helping create the “Below the Surface” campaign, Hawthorne said, is one of the best things he’s done in his life so far. The discussions were open and honest, and without adult interjection. “It wasn’t something that was manufactured by adults for kids,” he said. “It wasn’t trying to be hip. It was coming from us and it was based on things that we felt or we knew that other people felt.”

Each poster, Hawthorne said, “had a face with it.” Hawthorne, who identifies as gay, is particularly proud of the poster that speaks directly to LGBTQ kids who are scared to come out. “Sometimes fear lies just below the surface,” it says.

Another poster is aimed at immigrants: “My family loves a country that doesn’t want us. Sometimes rejection lies just below the surface.”

McCowan, who is 19 and now a sophomore at the University of Northern Colorado, was invited to the panel because she had spoken out at a youth leadership summit about busting the stigma of mental illness. The first suicide of a student at James Irwin Charter High School, the younger brother of her friend, happened the year after McCowan graduated.

“In my own high school, there was very little talk of mental illness and what that meant,” she said. “Any sort of interaction with someone who may be a little ‘strange’ was not happening. But I had friends in other schools and districts where they were dropping like flies, for lack of a better term. It’s an epidemic.”

For McCowan, the most crucial point of the text line is that it is a window to mental health care. “A lot of young adults don’t have access to counselors or they can’t afford therapy,” she said. “We really wanted to have a system that was noninvasive and open to all.”

Teen ambassadors will spread the campaign

Text TALK to 38255 and a counselor will text back, 24 hours a day, seven days a week.

The line is answered by Colorado Crisis Services, a statewide network of walk-in mental health clinics and stabilization centers created in response to the 2012 mass murder at an Aurora movie theater by a college student who was experiencing a psychotic break.

The conversation is confidential, though by law, the counselor must report to authorities if someone commits child abuse or neglect, or says they plan to harm others. Counselors who answer the texts can connect those who need it to follow-up, in-person mental health care.

Stickers promoting a text line are part of a statewide awareness campaign to prevent youth suicide. The stickers were created by the Colorado Springs affiliate of the National Alliance on Mental Illness, or NAMI. (Mark Reis, Special to The Colorado Sun)

The state’s new youth leadership program deploys teens to market the campaign in their schools, with an emphasis on counties where the youth suicide rates are the highest. The effort also includes videos posted on Instagram and other social media featuring teens talking about the pressures of academics, getting into college or the death of loved one. “This campaign is going to make the text line much more widely known,” said Dr. Robert Werthwein, director of the state Office of Behavioral Health.

Before the state adopted the campaign, the state and NAMI signed an intellectual property agreement, aiming to protect what NAMI saw as the key ingredient of the campaign: teen voices.

“The biggest concern for us is that there wouldn’t be any new messaging created that wouldn’t come from teenagers,” Woundy said. “You don’t want to feel like you are trying to get into the head of a 17-year-old boy or girl as a 40-year-old-something person. It’s just not going to work.”

Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.


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